Individual provider Active NPI

Brittany Leigh Brecklin, AGNP

  • Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1467903518
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11005461 Issued in FL
Practice address
409 Bayshore Blvd
Tampa, FL 33606-2707
Phone
(813) 844-5470
Fax
(813) 844-1655
NPI assigned
Oct 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11005461 FL Primary
Primary Care Nurse Practitioner 363LP2300X 2010021333 MO

Addresses

Primary practice location

409 Bayshore Blvd
Tampa, FL 33606-2707

Mailing address

PO Box 1289
Tampa, FL 33601-1289
Phone (813) 844-5470

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bbrecklin178857@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201214000612 FL Practitioner - Nurse Practitioner 5698034817 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

409 Bayshore Blvd
FL 4
Tampa, FL 33606-2707
Phone (813) 910-8708

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11005461FLMDNurse Practitioner
2010021333MOMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Kidney Physicians , LLC CurrentSince Jul 6, 2022 Accepting new patients
Tampa General Medical Group Inc CurrentSince Dec 14, 2020 Accepting new patients
Tampa General Medical Group Inc CurrentSince Dec 14, 2020 Accepting new patients
Florida Kidney Physicians, LLC CurrentSince Jul 6, 2022 Accepting new patients
Tampa General Hospital Current Accepting new patients
Tampa General Medical Group Inc Current Accepting new patients

Locations

214 Morrison Rd
Ste 110
Brandon, FL 33511
Phone (800) 844-9302

1150 N 35th Ave
Ste 620
Hollywood, FL 33021
Phone (954) 612-8173

19056 NE 29th Ave
Miami, FL 33180
Phone (305) 354-4558

409 Bayshore Blvd
Tampa, FL 33606
Phone (813) 253-2640

409 Bayshore Blvd
Fl 4
Tampa, FL 33606
Phone (813) 910-8708

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: bbrecklin178857@direct.tgh.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1467903518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1289",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336011289",
            "telephone_number": "813-844-5470",
            "fax_number": "813-844-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 BAYSHORE BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062707",
            "telephone_number": "813-844-5470",
            "fax_number": "813-844-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRECKLIN",
        "first_name": "BRITTANY",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-24",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11005461",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2010021333",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbrecklin178857@direct.tgh.org",
            "affiliation": "N",
            "address_1": "409 Bayshore Blvd",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336062707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.